Fries J F
Department of Medicine, Stanford University School of Medicine, CA 94304.
J Rheumatol Suppl. 1991 Mar;28:6-10.
Nonsteroidal antiinflammatory drug (NSAID) gastrointestinal (GI) pathology (gastropathy) accounts for over 70,000 hospitalizations and over 7,000 deaths annually in the United States. Not all patients, however, are at equal risk. Major risk factors for serious events (hospitalization or death) in patients with rheumatoid arthritis (RA) are age, level of disability, concurrent use of prednisone, prior NSAID side effects and NSAID dose. For the average patient with RA, the chance of hospitalization or death due to a GI event is about 1.3 to 1.6% over the course of 12 months and about 1 in 3 over the entire course of the disease. Subgroups of patients have risks ranging from nearly zero to as high as 4 or 5%/years. A simple scoring system based on multivariate analysis of risk factors permits the clinician to directly calculate the risk for the individual patient.
在美国，非甾体抗炎药（NSAID）所致的胃肠道（GI）病变（胃病）每年导致超过70,000例住院治疗和超过7,000例死亡。然而，并非所有患者都面临同等风险。类风湿关节炎（RA）患者发生严重事件（住院或死亡）的主要风险因素包括年龄、残疾程度、同时使用泼尼松、既往NSAID副作用以及NSAID剂量。对于普通RA患者，在12个月内因GI事件住院或死亡的几率约为1.3%至1.6%，在整个病程中约为三分之一。患者亚组的风险范围从几乎为零到高达每年4%或5%。基于风险因素多变量分析的简单评分系统使临床医生能够直接计算个体患者的风险。
